Ness County Hospital

All Charges

Charge

Type

Setting

Price

FACIAL BONES 3 VIEW MINIMUM

Facility

$357.00

Service Code	HCPCS 70150
Hospital Charge Code	3260022
Hospital Revenue Code	320
Min. Negotiated Rate	$164.93
Max. Negotiated Rate	$346.29
Rate for Payer: BCBS Commercial	$189.56
Rate for Payer: Cash Price	$267.75
Rate for Payer: Cash Price	$267.75
Rate for Payer: Celtic Commercial/Exchange	$164.93
Rate for Payer: Health Partners Plans Commercial	$339.15
Rate for Payer: UnitedHealthcare Commercial	$346.29
Rate for Payer: WPPA Commercial	$299.88

FACIAL BONES 3 VIEW MINIMUM

Facility

$357.00

Service Code	HCPCS 70150
Hospital Charge Code	3260022
Hospital Revenue Code	320
Min. Negotiated Rate	$292.74
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$267.75
Rate for Payer: Health Partners Plans Commercial	$339.15
Rate for Payer: UnitedHealthcare Commercial	$346.29
Rate for Payer: WPPA Commercial	$292.74

FACIAL BONES < 3 VIEWS

Facility

$231.00

Service Code	HCPCS 70140
Hospital Charge Code	3260014
Hospital Revenue Code	320
Min. Negotiated Rate	$106.72
Max. Negotiated Rate	$224.07
Rate for Payer: BCBS Commercial	$179.34
Rate for Payer: Cash Price	$173.25
Rate for Payer: Cash Price	$173.25
Rate for Payer: Celtic Commercial/Exchange	$106.72
Rate for Payer: Health Partners Plans Commercial	$219.45
Rate for Payer: UnitedHealthcare Commercial	$224.07
Rate for Payer: WPPA Commercial	$194.04

FACIAL BONES < 3 VIEWS

Facility

$231.00

Service Code	HCPCS 70140
Hospital Charge Code	3260014
Hospital Revenue Code	320
Min. Negotiated Rate	$189.42
Max. Negotiated Rate	$224.07
Rate for Payer: Cash Price	$173.25
Rate for Payer: Health Partners Plans Commercial	$219.45
Rate for Payer: UnitedHealthcare Commercial	$224.07
Rate for Payer: WPPA Commercial	$189.42

FACTOR INHIBITOR TEST

Facility

$87.00

Service Code	HCPCS 85335
Hospital Charge Code	8533500
Hospital Revenue Code	305
Min. Negotiated Rate	$71.34
Max. Negotiated Rate	$84.39
Rate for Payer: Cash Price	$65.25
Rate for Payer: Health Partners Plans Commercial	$82.65
Rate for Payer: UnitedHealthcare Commercial	$84.39
Rate for Payer: WPPA Commercial	$71.34

FACTOR INHIBITOR TEST

Facility

$87.00

Service Code	HCPCS 85335
Hospital Charge Code	8533500
Hospital Revenue Code	305
Min. Negotiated Rate	$40.19
Max. Negotiated Rate	$84.39
Rate for Payer: BCBS Commercial	$62.57
Rate for Payer: Cash Price	$65.25
Rate for Payer: Cash Price	$65.25
Rate for Payer: Celtic Commercial/Exchange	$40.19
Rate for Payer: Health Partners Plans Commercial	$82.65
Rate for Payer: UnitedHealthcare Commercial	$84.39
Rate for Payer: WPPA Commercial	$73.08

FACTOR V

Facility

$257.00

Service Code	HCPCS 81241
Hospital Charge Code	8124100
Hospital Revenue Code	307
Min. Negotiated Rate	$118.73
Max. Negotiated Rate	$249.29
Rate for Payer: BCBS Commercial	$175.14
Rate for Payer: Cash Price	$192.75
Rate for Payer: Cash Price	$192.75
Rate for Payer: Celtic Commercial/Exchange	$118.73
Rate for Payer: Health Partners Plans Commercial	$244.15
Rate for Payer: UnitedHealthcare Commercial	$249.29
Rate for Payer: WPPA Commercial	$215.88

FACTOR V

Facility

$257.00

Service Code	HCPCS 81241
Hospital Charge Code	8124100
Hospital Revenue Code	307
Min. Negotiated Rate	$210.74
Max. Negotiated Rate	$249.29
Rate for Payer: Cash Price	$192.75
Rate for Payer: Health Partners Plans Commercial	$244.15
Rate for Payer: UnitedHealthcare Commercial	$249.29
Rate for Payer: WPPA Commercial	$210.74

FACTOR V HR2 ALLELE DNA MUTATI

Facility

$300.00

Service Code	HCPCS 81400
Hospital Charge Code	8140000
Hospital Revenue Code	300
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$291.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Health Partners Plans Commercial	$285.00
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: WPPA Commercial	$246.00

FACTOR V HR2 ALLELE DNA MUTATI

Facility

$300.00

Service Code	HCPCS 81400
Hospital Charge Code	8140000
Hospital Revenue Code	300
Min. Negotiated Rate	$89.26
Max. Negotiated Rate	$291.00
Rate for Payer: BCBS Commercial	$89.26
Rate for Payer: Cash Price	$225.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Celtic Commercial/Exchange	$138.60
Rate for Payer: Health Partners Plans Commercial	$285.00
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: WPPA Commercial	$252.00

FACTOR VIII ACTIVITY, CLOTTING

Facility

$164.00

Service Code	HCPCS 85240
Hospital Charge Code	8524002
Hospital Revenue Code	305
Min. Negotiated Rate	$134.48
Max. Negotiated Rate	$159.08
Rate for Payer: Cash Price	$123.00
Rate for Payer: Health Partners Plans Commercial	$155.80
Rate for Payer: UnitedHealthcare Commercial	$159.08
Rate for Payer: WPPA Commercial	$134.48

FACTOR VIII ACTIVITY, CLOTTING

Facility

$164.00

Service Code	HCPCS 85240
Hospital Charge Code	8524002
Hospital Revenue Code	305
Min. Negotiated Rate	$75.77
Max. Negotiated Rate	$159.08
Rate for Payer: BCBS Commercial	$88.47
Rate for Payer: Cash Price	$123.00
Rate for Payer: Cash Price	$123.00
Rate for Payer: Celtic Commercial/Exchange	$75.77
Rate for Payer: Health Partners Plans Commercial	$155.80
Rate for Payer: UnitedHealthcare Commercial	$159.08
Rate for Payer: WPPA Commercial	$137.76

FACTOR VIII,CLOTTING W/REFLEX

Facility

$164.00

Service Code	HCPCS 85240
Hospital Charge Code	8524001
Hospital Revenue Code	305
Min. Negotiated Rate	$75.77
Max. Negotiated Rate	$159.08
Rate for Payer: BCBS Commercial	$88.47
Rate for Payer: Cash Price	$123.00
Rate for Payer: Cash Price	$123.00
Rate for Payer: Celtic Commercial/Exchange	$75.77
Rate for Payer: Health Partners Plans Commercial	$155.80
Rate for Payer: UnitedHealthcare Commercial	$159.08
Rate for Payer: WPPA Commercial	$137.76

FACTOR VIII,CLOTTING W/REFLEX

Facility

$164.00

Service Code	HCPCS 85240
Hospital Charge Code	8524001
Hospital Revenue Code	305
Min. Negotiated Rate	$134.48
Max. Negotiated Rate	$159.08
Rate for Payer: Cash Price	$123.00
Rate for Payer: Health Partners Plans Commercial	$155.80
Rate for Payer: UnitedHealthcare Commercial	$159.08
Rate for Payer: WPPA Commercial	$134.48

FACTOR VIII INHIBITOR PANEL

Facility

$251.00

Hospital Charge Code	8888914
Hospital Revenue Code	305
Min. Negotiated Rate	$205.82
Max. Negotiated Rate	$243.47
Rate for Payer: Cash Price	$188.25
Rate for Payer: Health Partners Plans Commercial	$238.45
Rate for Payer: UnitedHealthcare Commercial	$243.47
Rate for Payer: WPPA Commercial	$205.82

FACTOR VIII INHIBITOR PANEL

Facility

$251.00

Hospital Charge Code	8888914
Hospital Revenue Code	305
Min. Negotiated Rate	$115.96
Max. Negotiated Rate	$243.47
Rate for Payer: Cash Price	$188.25
Rate for Payer: Celtic Commercial/Exchange	$115.96
Rate for Payer: Health Partners Plans Commercial	$238.45
Rate for Payer: UnitedHealthcare Commercial	$243.47
Rate for Payer: WPPA Commercial	$210.84

FALL PAD MONITOR

Facility

$127.00

Hospital Charge Code	9999901
Hospital Revenue Code	270
Min. Negotiated Rate	$104.14
Max. Negotiated Rate	$123.19
Rate for Payer: Cash Price	$95.62
Rate for Payer: Health Partners Plans Commercial	$120.65
Rate for Payer: UnitedHealthcare Commercial	$123.19
Rate for Payer: WPPA Commercial	$104.14

FALL PAD MONITOR

Facility

$127.00

Hospital Charge Code	9999901
Hospital Revenue Code	270
Min. Negotiated Rate	$58.67
Max. Negotiated Rate	$123.19
Rate for Payer: Cash Price	$95.62
Rate for Payer: Celtic Commercial/Exchange	$58.67
Rate for Payer: Health Partners Plans Commercial	$120.65
Rate for Payer: UnitedHealthcare Commercial	$123.19
Rate for Payer: WPPA Commercial	$106.68

FAT OR LIPIDS,FECES QUAL.

Facility

$30.00

Service Code	HCPCS 82705
Hospital Charge Code	8270500
Hospital Revenue Code	301
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: BCBS Commercial	$17.72
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

FAT OR LIPIDS,FECES QUAL.

Facility

$30.00

Service Code	HCPCS 82705
Hospital Charge Code	8270500
Hospital Revenue Code	301
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

FAT OR LIPIDS, FECES QUANT.

Facility

$109.00

Service Code	HCPCS 82710
Hospital Charge Code	8271000
Hospital Revenue Code	301
Min. Negotiated Rate	$50.36
Max. Negotiated Rate	$105.73
Rate for Payer: BCBS Commercial	$63.35
Rate for Payer: Cash Price	$81.75
Rate for Payer: Cash Price	$81.75
Rate for Payer: Celtic Commercial/Exchange	$50.36
Rate for Payer: Health Partners Plans Commercial	$103.55
Rate for Payer: UnitedHealthcare Commercial	$105.73
Rate for Payer: WPPA Commercial	$91.56

FAT OR LIPIDS, FECES QUANT.

Facility

$109.00

Service Code	HCPCS 82710
Hospital Charge Code	8271000
Hospital Revenue Code	301
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$105.73
Rate for Payer: Cash Price	$81.75
Rate for Payer: Health Partners Plans Commercial	$103.55
Rate for Payer: UnitedHealthcare Commercial	$105.73
Rate for Payer: WPPA Commercial	$89.38

FAT STAIN,FECES,URINE,RESP

Facility

$38.00

Service Code	HCPCS 89125
Hospital Charge Code	8912500
Hospital Revenue Code	309
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$36.86
Rate for Payer: BCBS Commercial	$21.68
Rate for Payer: Cash Price	$28.50
Rate for Payer: Cash Price	$28.50
Rate for Payer: Celtic Commercial/Exchange	$17.56
Rate for Payer: Health Partners Plans Commercial	$36.10
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: WPPA Commercial	$31.92

FAT STAIN,FECES,URINE,RESP

Facility

$38.00

Service Code	HCPCS 89125
Hospital Charge Code	8912500
Hospital Revenue Code	309
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$36.86
Rate for Payer: Cash Price	$28.50
Rate for Payer: Health Partners Plans Commercial	$36.10
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: WPPA Commercial	$31.16

FATTY ACIDS, NONESTERIFIED

Facility

$57.00

Service Code	HCPCS 82725
Hospital Charge Code	8272500
Hospital Revenue Code	301
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$55.29
Rate for Payer: BCBS Commercial	$31.87
Rate for Payer: Cash Price	$42.75
Rate for Payer: Cash Price	$42.75
Rate for Payer: Celtic Commercial/Exchange	$26.33
Rate for Payer: Health Partners Plans Commercial	$54.15
Rate for Payer: UnitedHealthcare Commercial	$55.29
Rate for Payer: WPPA Commercial	$47.88

Know your out-of-pocket cost for care.

All Charges